Reasonable Hospital Billing?

Question

When I was on Holiday in the States, looking in back in hind sight I understand that my 11 year old daughter pinched a nerve and she had a extreme pain in her upper leg/hip and she could not walk. It could have been due to all the bumpy rides at Knotts Berry Farm and Universal Studios from the proceeding 2 days.

As she was in so much pain I took her to the emergency part of the Hospital and got them to check her out. 

It took about 6 hours for them to take 2 x-rays and get her some analgesic.  The hospital asked for $500 which I paid.

The hospital gave her crutches and we left.

The next day we went to a shopping center and in was one of those, bouncing machines, where they strap you in a harness and you are bounced up and down.
My 11 year refused to go on (which is understandable being in a center provided wheel chair) but other 9 year daughter went on and relished it.

I supposed when my 11 year old saw the delight on the face her sister she, even though only on one leg, decided to give it a go.  She had a great time.

Afterwards the jaws of my wife and I simultaneously dropped and she was unharnessed after her ride and jumped of the air mat and walked away. 

What was causing her leg to be useless was a pinched nerve in her spine and the up and down g forces of the bouncing machine straightened her spine the pinch nerve (causing the pain) was restored.

However he is my reason for asking this question.

We received by mail a account for radiology for an additional $530 odd dollars a month later. In the next month we receive another account adding this payment.
However on the next monthly account (over 3 months after the event) they have added a $660 “Emergency Service” fee.

The question(s)  I have are:

Is this a reasonable charge for a triage nurse to fill out a clipboard and add a file to a computer data base and a doctor to look at an X-ray and then to poke and prod for 5 minutes?

Why wasn’t this charged on the previous 2 monthly accounts?
Is delay in billing this not unusual?

What is to stop the hospital from adding other different charges in the next monthly bill?

I supposed I am spoiled in living in Australia as visits to Emergency in Hospitals’ (public) are free, but I think this “sleeping charge” of $660USD is outrageous.

And yes after I pay it my travel insurance will cover the cost is just and I annoyed that this charge was unbilled for over 3 months. 

Any advise or comments appreciated

? · Accepted Answer

The delay in billing is not unusual.
Hospital ER charges are separate from Radiology bills. Fees for a doctor can be separate from the hospital and radiology, so you might yet see another bill. The initial $500 was probably just considered a down payment for services rendered, and the $660 was for the remainder of ER services. I think it's outrageous, but it's not unusual. It's the way things normally work here because it's the way insurance is billed. Most hospitals will offer discounts for uninsured patients, and work out a payment for those not filing through their insurance. For instance, The hospital charges $1000, it's filed through the insurance company who has a prenegotiated contract with the hospital to pay $450 on that claim amount. The insurance company pays $450, and the patient is not responsible for anything more. The bill is considered paid. Screwy, but that's the way it works! Sometimes a hospital will work with an uninsured patient to pay the amount that they would normally receive from an insurance company for a typical claim. Some hospitals don't do that. Some have mountains of paperwork that have to be filled out before any deal can be made. It all depends on the hospital and the mood of the financial services people you're working with, and hospital policy for this kind of thing. It's a mess.

? · Answer

The US hospital system uses fairly standardized billing. You will pay for everything, from the staff to the items they use. 

In a hospital not everything is part of the hospital. The doctors are contracted to be there as are the nurses. 

$660 is pretty standard. An average ER bill is around $1500. It would probably be cheaper if people would stop suing and skipping out on their bills. 

There is more to it than what I described but you would need to contact the individual hospital.

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Reasonable Hospital Billing?

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